Active NPI
Crystal Brock Mullins, LCSW
- Clinical Social Worker
- Oak Ridge, TN
National Provider Identifier
1003483926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW0000004304
- Practice address
- The Sanctuary
300 Tyler Road, Suite 203
Oak Ridge, TN 37830 - Phone
- (865) 245-2333
- NPI assigned
- Jun 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW0000004304 | TN | Primary |
Addresses
Primary practice location
The Sanctuary
300 Tyler Road, Suite 203
Oak Ridge, TN 37830
Mailing address
260 Mountain Dr
Lenoir City, TN 37772-6971
Phone (865) 936-9230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW0000004304 | TN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1003483926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 MOUNTAIN DR",
"city": "LENOIR CITY",
"state": "TN",
"postal_code": "377726971",
"telephone_number": "865-936-9230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "THE SANCTUARY",
"address_2": "300 TYLER ROAD, SUITE 203",
"city": "OAK RIDGE",
"state": "TN",
"postal_code": "37830",
"telephone_number": "865-245-2333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINS",
"first_name": "CRYSTAL",
"middle_name": "BROCK",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-09",
"last_updated": "2021-06-09",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "LCSW0000004304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Ridge, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.